Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials.

CONTEXT

Evaluating the efficacy of pediatric weight loss treatments is critical.

OBJECTIVE

This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls.

DATA SOURCES

Medline, PsycINFO, and Cochrane Controlled Trials Register.

STUDY SELECTION

Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes.

DATA EXTRACTION

Standardized coding was used to extract information on design, participant characteristics, interventions, and results.

DATA SYNTHESIS

For trials with no-treatment controls, the mean effect size was 0.75 (k = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (k = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (k = 4, CI = 0.13-0.82) at end of treatment and 0.91 (k = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified.

CONCLUSIONS

Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. Future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.